Antibiotics for common childhood infections no longer effective in many parts of world: Lancet study

Drugs to treat common infections in children and babies are no longer effective in large parts of the world, including India, due to high rates of antibiotic resistance, a study has found.

The team led by researchers at the University of Sydney in Australia found many antibiotics recommended by the World Health Organization (WHO) had less than 50 per cent effectiveness in treating childhood infections such as pneumonia, sepsis (bloodstream infections) and meningitis.

The findings, published in The Lancet regional Health-Southeast Asia journal, show global guidelines on antibiotic use are outdated and need updates.

The most seriously affected regions are in Southeast Asia and the Pacific where thousands of unnecessary deaths in children resulting from antibiotic resistance occur each year, the researchers said.

The WHO has declared that antimicrobial resistance (AMR) is one of the top 10 global public health threats facing humanity. In newborns, an estimated three million cases of sepsis occur globally each year, with up to 570,000 (5.7 lakh) deaths.

Many of these are due to lack of effective antibiotics to treat resistant bacteria.

The study adds to mounting evidence that common bacteria responsible for sepsis and meningitis in children are often resistant to prescribed antibiotics.

The research shows the urgent need for global antibiotic guidelines to be updated, to reflect the rapidly evolving rates of AMR. The most recent guidelines from the WHO were published in 2013.

The study found that one antibiotic in particular, ceftriaxone, was likely to be effective in treating only one in three cases of sepsis or meningitis in newborn babies.

Another antibiotic, gentamicin, was found likely to be effective in treating fewer than half of all sepsis and meningitis cases in children, according to the researchers.

Gentamicin is commonly prescribed alongside aminopenicillins, which the study showed also has low effectiveness in combating bloodstream infections in babies and children.

"Antibiotic resistance is rising more rapidly than we realize," said study lead author Phoebe Williams from the University of Sydney.

"We urgently need new solutions to stop invasive multidrug-resistant infections and the needless deaths of thousands of children each year," Williams said.

The study analysed 6,648 bacterial isolates from 11 countries across 86 publications to review antibiotic susceptibility for common bacteria causing childhood infections.

The data collated largely arose from urban tertiary hospital settings with over-representation from particular countries, especially India and China.

Williams said that the best way to tackle antibiotic resistance in childhood infections is to make funding to investigate new antibiotic treatments for children and newborns a priority.

"Antibiotic clinical focus on adults and too often children and newborns are left out. That means we have very limited options and data for new treatments," she noted.

"This study reveals important problems regarding the availability of effective antibiotics to treat serious infections in children," said study senior author Paul Turner, a professor at the University of Oxford, UK.

"It also highlights the ongoing need for high quality laboratory data to monitor the AMR situation, which will facilitate timely changes to be made to treatment guidelines," Turner added.